It hurts under the last rib

There are many reasons for pain below the last rib, including liver pain, intercostal neuralgia, trauma, abdominal intestinal tract or cold. The specific cause needs to be determined based on the individual's situation and past medical history. Let us now understand the symptoms and treatment of intercostal neuralgia.

Intercostal neuralgia is a subjective symptom of the patient. The intercostal nerves extend from the thoracic spinal cord to both sides through the intercostals to the anterior chest wall, innervating the muscles of the back and chest wall beside the corresponding thoracic vertebrae and the sensory branches running along the intercostals. Therefore, intercostal neuralgia is pain in a band-like area that extends from the chest and back along the intercostals diagonally forward and downward to the midline of the anterior wall of the chest and abdomen.

Causes

Degenerative protrusion of the thoracic intervertebral disc, thickening and ossification of the joint capsule and ligaments often lead to narrowing and deformation of the nerve channels, which can cause inflammation of the intercostal nerves and produce pain. Other lesions that may affect the intercostal nerves include thoracic tuberculosis, thoracic fracture or dislocation, spinal or spinal cord tumors, ankylosing spondylitis, and rib, mediastinal, and pleural lesions. The pain of herpes zoster intercostal neuralgia is often severe.

Clinical manifestations

Intercostal neuralgia refers to pain in one or several intercostal areas that radiates from the back along the intercostals to the anterior wall of the chest and abdomen, in a semi-circular distribution. It is usually unilateral, but can also affect both sides simultaneously. The pain is often made worse by coughing, taking deep breaths, or sneezing. Physical examination may reveal tenderness and percussion pain in the thoracic spinous processes, between the spinous processes or beside the vertebrae. A few patients may have tenderness along the intercostals and paresthesias in the areas innervated by the affected nerves. The pain is usually stabbing or burning, and radiates along the intercostal nerves. Local lesions may be seen in herpes zoster.

diagnosis

To establish a diagnosis, we must first identify it as intercostal neuralgia based on the characteristic distribution of pain. Then, more importantly, we must think of and find out the cause of the intercostal neuralgia, especially considering important diseases that are easily overlooked, such as tuberculosis, tumors, osteoporotic compression fractures in the elderly, and early herpes zoster.

treat

Treatment should be directed at the cause of the intercostal neuralgia, so the treatment approach should be tailored to the cause established.

Precautions

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1. To avoid colds when the weather turns cold, open windows frequently to keep the indoor air fresh;

2. Participate in more sports activities to enhance your resistance, pay attention to the combination of work and rest, and avoid overwork;

3. Keep warm at ordinary times. Do not take off your clothes immediately when you sweat, so as not to catch a cold;

4. Pay attention to raising awareness of protection when working, lift heavy objects in the correct posture, and beware of chest and costal cartilage and ligament injuries;

5. Eat more foods such as leeks, oranges, dog meat, red beans, etc., which have auxiliary therapeutic effects of relaxing muscles and tendons and relieving pain.